Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Hardin-Fanning, Frances

Committee Member

Witt, Cheryl

Author's Keywords

HbA1c; Glycated hemoglobin; Diabetes; Oral Health; Dental; Periodontal


Oral health and diabetes are connected in a reciprocal relationship linked through the pathological mechanisms of bacteremia, inflammation, and the immune response. Dental patients experience a delay in receiving treatment at a university-based dental clinic secondary to obtaining required medical consultation from the patients’ private providers for complex medical conditions. This project was implemented to minimize barriers in access to care, reduce the risk for oral health and systemic diabetes complications, and optimize the health outcomes for diabetic patients seeking comprehensive dental treatment. The intervention group included 32 patients with diabetes who participated in hemoglobin A1c (HbA1c) testing during their initial dental screening appointment. The participants whose HbA1c value was ≤ 9.0% were expedited into the scheduling queue for the next comprehensive examination appointment. The timeframe between screening and dental treatment plan development was measured and compared to a retrospective cohort of diabetic patients. Health literacy was assessed regarding patients’ understanding of the connection between oral health and diabetes. The mean number of days between screening and treatment plan development was decreased from 125 to 68 days, a 45% reduction. Most of the eligible participants in the intervention group with an HbA1c value ≤ 9.0% rated their understanding of the connection between diabetes and gum disease as “poor” (44%), whereas 86% of the patients who consented to participate but were ineligible due to an HbA1c value ≥ 9.1% rated their understanding as “very good” or “excellent”. Diabetic patients will continue to benefit from this quality improvement project to minimize barriers to dental care and improve overall health outcomes as this intervention is adopted as a permanent practice change.

Included in

Nursing Commons